This poster was presented by Antonia Mesquita and Elaine Rossi at the International Conference on Family Planning (ICFP) in Kigali, Rwanda in November 2018.
USAID’s Reinforce Basic Health Services Project, implemented by JSI Research & Training Institute, Inc., works in Covalima Municipality, Timor-Leste to improve family planning (FP) services with a specific focus on quality of care (QOC). JSI developed a model municipality
approach, which merges data-driven processes with demand generation from clients and skilled providers to bring QOC to the forefront of FP services.
Becoming a Model Municipality: Improving Quality of Care for Family Planning in Timor-Leste
1. Timor-Leste
BECOMING A MODEL MUNICIPALITY:
IMPROVING QUALITY OF CARE FOR FAMILY
PLANNING IN TIMOR-LESTE
AUTHORS: Antonia Mesquita, Julio Goncalves, Elizabeth Bunde, Marianne Viatour, and Elaine Rossi—JSI Research & Training Institute, Inc.
BACKGROUND
USAID’s Reinforce Basic Health Services
Project, implemented by JSI Research &
Training Institute, Inc., works in Covalima
Municipality, Timor-Leste to improve family
planning (FP) services with a specific focus
on quality of care (QOC).
CONCLUSIONS
RESULTS
Facility-level
Out of the 25 health facilities in the district, all are staffed with health
providers certified to provide FP counseling and short-acting methods.
Among these, 17 have at least one provider certified to also provide one
or both long-acting reversible contraceptive methods (implants and IUDs).
All seven community health centers (CHCs) and five health posts (HPs)
meet national readiness and service availability standards.
Average contraceptive stockout rates across all facilities/methods have
decreased from 36% to 21%.
METHODOLOGY
JSI developed a model municipality
approach, which merges DATA-DRIVEN
PROCESSES with demand generation from
clients and SKILLED PROVIDERS to bring
QOC to the forefront of FP services.
PROGRAM INTERVENTION
A model municipality: well-trained and
competent health providers receiving consistent,
high-quality supervision and delivering quality
FP services in fully-equipped, people-friendly
health facilities.
1. Conducted Baseline Survey: to identify health facility
needs to improve FP services and to identify FP messages
that would resonate with the community.
2. Provided Training and Supportive Supervision:
in FP counseling and IUD/implant insertion to maintain
provider competency and improve health facility readiness.
3. Developed and Implemented SBCC Plan: to increase
community demand for and use of FP services.
4. Advocated for Community Leaders: to promote FP
and help communities overcome obstacles to obtaining
FP services.
5. Integrated Use of Data: to monitor results, plan
improvements, and promote data-driven decision-making.
Out of the 25 facilities in Covalima, the number
of facilities now staffed with at least one health
provider certified to provide specific services:
provide
safe
and clean
delivery20 21 15
provide
integrated
management
of childhood
illnesses
provide
essential
newborn
care
72% of all the communities in the district
have participated in FP-focused community
discussion groups.
1. Achieving a model
municipality requires
coordination between
government, facilities,
and communities.
Couple Years of Protection (CYPs) Increased
Two-fold Since Project Began
0
2,000
4,000
6,000
8,000
2,042
3,876
4,697
5,052
Baseline Year 1 Year 2 Year 3
Since the project began, there has been a three-fold increase in injectable
contraceptive CYPs, a five-fold increase in pill CYPs, and a 60% increase in
the proportion of CYPs attributed to implants.
Community-level
72% of all the communities in the district have participated in FP-focused
community discussion groups.
Four villages have developed action plans to improve community access to
FP services, especially around innovative transport options for couples seeking
FP services.
2. Increasing clinical
competency for insert-
ing implants and IUDs
expands contraceptive
options for women.
3. Following-up with post-
training support increases
provider confidence and
maintains skills; technical
competence is not a
one-time investment.
4. Supplying health facilities
with appropriate materials,
equipment, and commodi-
ties, supported by effective
management helps meet
patient needs.
5. Empowering community
members to understand
their options and demand
appropriate services can
effect change in the
system when needed.